ABSTRACT
BACKGROUND: We aimed to examine the association of pelvic fracture sites with the minimum fibrinogen level within 24 h after hospital arrival. METHODS: We conducted a single-center cohort study using health records review. We included patients with pelvic fractures transported by ambulance to a tertiary-care hospital from January 2012 to December 2018 and excluded those transported from other hospitals or aged younger than 16 years. The pelvic fracture was diagnosed and confirmed by trauma surgeons and/or radiologists. We classified the fracture sites of the pelvis as ilium, pubis, ischium, acetabulum, sacrum, sacroiliac joint diastasis, and pubic symphysis diastasis, and each side was counted separately except for pubic symphysis diastasis. We performed linear regression analysis to evaluate the association between pelvic fracture sites and the minimum fibrinogen level within 24 h of arrival. RESULTS: We analyzed 120 pelvic fracture patients. Their mean age was 47.3 years, and 69 (57.5%) patients were men. The median Injury Severity Score was 24, and in-hospital mortality was 10.8%. The mean minimum fibrinogen level within 24 h of arrival was 171.4 mg/dL. Among pelvic fracture sites, only sacrum fracture was statistically significantly associated with the minimum fibrinogen level within 24 h of arrival (estimate, -34.5; 95% CI, -58.6 to -10.4; p = 0.005). CONCLUSIONS: Fracture of the sacrum in patients with pelvic fracture was associated with lower minimum fibrinogen levels within 24 h of hospital arrival and the requirement of blood transfusion.
ABSTRACT
BACKGROUND: Complications in survivors after typical hanging have not been well characterized because of the high mortality rate. CASE PRESENTATION: We present a patient with bilateral vocal cord paralysis following typical hanging. A 39-year-old man with depression attempted suicide by hanging. He was in a coma and was transported to our hospital. Emergency endotracheal intubation was carried out. After 10 days of mechanical ventilation, he was extubated. After extubation, his voice was hoarse and stridor was heard. Vocal cord paralysis became apparent by laryngeal fiberscopy, and a tracheotomy was carried out. It resolved gradually 2 months after injury without surgery or drug treatment. CONCLUSION: Although vocal cord paralysis after typical hanging is rare, there is a need for adequate assessment of the airways in survivors of typical hanging as a differential diagnosis of airway edema after extubation.
